M1A

Header — not billable

Chronic gout

The ICD-10 code for chronic gout is M1A.

M1A is a non-billable header code. It groups related conditions but cannot be used on its own for reimbursement — select one of the 6 more specific codes below.

Clinical notes

Excludes1 (not coded here)

An Excludes1 note is a pure exclusion: the excluded condition and this code should never be reported together, because the two conditions cannot occur at the same time (e.g. a congenital form vs. an acquired form of the same disease).

gout NOS (M10.-)

Excludes2 (not included here)

An Excludes2 note means the excluded condition is not part of this one, but a patient can have both at the same time — in that case both codes may be reported together.

acute gout (M10.-)

7th character definitions

These definitions specify what each valid 7th-character value means for codes in this category.

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7th character note

This category requires a 7th character to indicate additional clinical detail (e.g. encounter type: initial, subsequent, sequela). The code is incomplete without it.

The appropriate 7th character is to be added to each code from category M1A

Use additional code

This code represents an underlying condition. When a related manifestation is also present, coding convention calls for an additional code to be listed after this one.

code to identify:
Autonomic neuropathy in diseases classified elsewhere (G99.0)
Calculus of urinary tract in diseases classified elsewhere (N22)
Cardiomyopathy in diseases classified elsewhere (I43)
Disorders of external ear in diseases classified elsewhere (H61.1-, H62.8-)
Disorders of iris and ciliary body in diseases classified elsewhere (H22)
Glomerular disorders in diseases classified elsewhere (N08)

Documentation support

General coding-documentation guidance — not a substitute for payer-specific requirements or professional coding judgment.

•This is a non-billable header code. Documentation must support a more specific child code before this diagnosis can be reported on a claim.
•Confirm the excluded condition(s) listed above are not also present — Excludes1 conditions cannot be coded together with this one.
•If the associated manifestation or related condition noted above is also documented, an additional code should be reported alongside this one.
•This category requires a 7th character. Documentation should clearly indicate the episode of care (initial encounter, subsequent encounter, or sequela).
•As a general rule, code to the highest level of specificity supported by the documentation in the medical record.

M1A